曼彻斯特手术治疗盆腔脏器脱垂患者的效果观察

摘要
图/表
参考文献(29)
相关文章 (0)

全文: PDF (524 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的评估曼彻斯特手术治疗盆腔脏器脱垂患者的效果。方法对2009年1月~2016年1月在安徽省立医院行曼彻斯特手术治疗的83例盆腔脏器脱垂患者的临床资料进行回顾性分析。记录患者手术时间、出血情况和术后恢复情况；通过门诊就诊、电话咨询和问卷调查，随访患者自觉症状、盆腔检查、生活质量等情况。结果 83例患者均无手术其他损伤、死亡。<60岁与≥60岁的患者手术时间比较[（82.31±36.91）mL比（70.18±33.62）mL]，差异有统计学意义（P < 0.05）；而平均手术时间[（105.52±46.29）min比（81.28±32.47）min]、平均术后住院日[（6.46±1.71）d比（6.51±1.36）d]比较，差异无统计学意义（P > 0.05）。术后1个月POP-Q评分提示脱垂症状较术前明显改善，差异有统计学意义（P < 0.05）。患者术后盆底功能障碍问卷和盆底功能影响问卷得分均较术前明显降低，差异有高度统计学意义（P < 0.01）；术后性生活质量问卷得分较前降低，差异无统计学意义（P > 0.05）。结论曼彻斯特手术作为一种治疗盆腔脏器脱垂的传统手术方式，能够改善盆腔脏器脱垂患者的脱垂症状，提高患者的生活质量，是一种行之有效的治疗方法。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	申震方政周颖彭程吴大保

关键词 ：曼彻斯特手术, 盆腔脏器脱垂, 宫颈延长

Abstract：Objective To evaluate the therapeutic effect of Manchester surgery in patients with pelvic organ prolapse. Methods A retrospective analysis was made on 83 cases with pelvic organ prolapse who were treated with Manchester surgery in Provincial Hospital Affiliated to Anhui Medical University from January 2009 to January 2016. The operation time, intraoperative bleeding and postoperative recovery of patients were recorded; the subjective symptoms, pelvic examination and the quality of life of patients were followed up through clinic and telephone consultation and questionnaire survey. Results 83 patients had no surgery injury or death. The average blood loss of patients of <60 years and ≥60 years [(82.31±36.91) mL vs (70.18±33.62) mL] had statistically significant difference (P < 0.05); while the mean operative time [(105.52±46.29) min vs (81.28±32.47) min], hospitalization time [(6.46±1.71) d vs (6.51±1.36) d] had no statistically significant difference (P > 0.05). The POP-Q scores postoperative showed that the symptoms of prolapse were improved significantly compared with before operation, the difference was statistically significant (P < 0.05). The pelvic floor incontinence questionnaire score and pelvic floor distress inventory score were significantly lower than those before surgery, the differences were statistically significant (P < 0.01); POP/urinary incontinence sexual questionnaire scored was lower than before surgery, with no significant difference (P > 0.05). Conclusion As a traditional surgical treatment of pelvic organ prolapse, Manchester surgery is still an effective method of treatment. Which can improve the prolapse symptoms and the quality of life.

Key words： Manchester surgery Pelvic organ prolapse Cervical extension

基金资助:安徽省科技攻关课题（1501041141）。

通讯作者: 吴大保（1963.2-），男，主任医师，硕士生导师，安徽省立医院妇产科主任；研究方向：妇科肿瘤、盆底和妇产科疑难杂症。

作者简介: 申震（1976.3-），男，硕士，副主任医师，副教授，硕士生导师，安徽省立医院妇产科妇瘤亚专科主任；研究方向：妇科肿瘤。

引用本文:

申震方政周颖彭程吴大保. 曼彻斯特手术治疗盆腔脏器脱垂患者的效果观察[J]. 中国医药导报, 2017, 14(33): 106-110.
SHEN Zhen FANG Zheng ZHOU Ying PENG Cheng WU Dabao. Therapeutic effect of Manchester surgery on patients with pelvic organ prolapse. 中国医药导报, 2017, 14(33): 106-110.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I33/106

[1] Dietz HP. The aetiology of prolapse [J]. Int J Urogynecol Pelvic Floor Dysfunct，2008，19（10）：1323-1329.
[2] Delancey JO，Kane Low L，Miller JM，et al. Graphic integration of causal factors of pelvic floor disorders：an integrated life span model [J]. Am J Obstet Gynecol，2008， 199（6）：610-615.
[3] Wu JM，Vaughan CP，Goode PS，et al. Prevalence and trends of symptomatic pelvic floor disorders in U.S. women [J]. Obstet Gynecol，2014，123（1）：141-148.
[4] Bump RC. Epidemiology and natural history ofpelvic floor dysfunction [J]. Obstet Gynecol Clin N Am，1998，25（4）：723-746.
[5] Swift SE，Tate SB，Nicholas J. Correlation of symptoms withdegree of pelvic organ support in a general population of women：what is pelvic organ prolapse? [J]. Am J Obstet Gynecol，2003，189（2）：372-377.
[6] Slieker-ten Hove MC，Pool-Goudzwaard AL，Eijkemans MJ，et al. Prediction model and prognostic index to estimate clinically relevant pelvic organ prolapse in a general female population [J]. Int Urogynecol J Pelvic Floor Dysfunct，2009，20（9）：1013-1021.
[7] Jha S，Gray T. A systematic review and meta-analysis of the impact of native tissue repair for pelvic organ prolapse on sexual function [J]. Int Urogynecol J，2015，26（3）：321-327.
[8] Ulrich D，Dwyer P，Rosamilia A，et al. The effect of vaginal pelvic organ prolapse surgery on sexual function [J]. Neurourol Urodyn，2015，34（4）：316-321.
[9] Abdel-Fattah M，Familusi A，Fielding S，et al. Primary and repeat surgical treatment for female pelvic organprolapse and incontinence in parous women in the UK：a registerlinkage study [J]. BMJ Open，2011，1（2）：e000206.
[10] Wu JM，Hundley AF，Fulton RG， et al.Forecasting theprevalence of pelvic floor disorders in U.S. Women，2010 to 2050 [J]. Obstet Gynecol，2009，114（6）：1278-1283.
[11] Kim YH，Kim JJ，Kim SM，et al. Association between metabolic syndrome and pelvic floor dysfunction in middleaged to older Korean women [J]. Am J Obstet Gynecol，2011，205（1）：71.e1-71.e8
[12] Panman CM，Wiegersma M，Talsma MN，et al. Sexual function in older women with pelvic floor symptoms：a cross-sectional study in general practice [J]. Br J Gen Pract，2014， 64（620）：e144-e150.
[13] Rogers RG，Coates KW，Kammerer-Doak D，et al. A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire （PISQ-12） [J]. Int Urogynecol J Pelvic Floor Dysfunction，2003，14（3）：164-168.
[14] Shaaban MM， Abdel wahab HA，Ahmed MR，et al. Assessment of female sexual function among women with pelvic organ prolapse or urinary incontinence via an Arabic validated short-form sexual questionnaire [J]. Int J Gynaecol Obstet，2014，124（1）：24-26.
[15] Zohre M，Minoo P，Ali M. Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire （PISQ-12）：psychometric validation of the Iranian version [J]. Int Urogynecol J，2015，26（3）：433-439.
[16] Salvatore S，Siesto G，Serati M. Risk factors for recurrence of genital prolapse [J]. Curr Opin Obstet Gynecol，2010，22（5）：420-424.
[17] Maher C，Feiner B，Baessler K，Schmid C. Surgical management of pelvic organ prolapse in women [M]. Cochrane Database Syst Rev，4,2013，CD004014.
[18] Kow N，Goldman HB，Ridgeway B. Management optionsfor women with uterine prolapse interested in uterinepreservation [M]. Curr Urol Rep，October，2013，14（5）：395-402.
[19] Dewan SK,Zheng SB,Xia SJ. Preoperative geriatric assessment：comprehensive,multidisciplinary and proactive [J]. Eur J Intern Med,2012，23（6）：487-494.
[20] Utomo E，Blok BF，Steensma AB，et al. Validation of the Pelvic Floor Distress Inventory （PFDI-20） and Pelvic Floor Impact Questionnaire （PFIQ-7） in a Dutch population [J]. Int Urogynecol J，2014，25（4）：531-544.
[21] Celik DB，Kizilkaya BN，Yalcin O. Sexual function in women after urinary incontinence and/or pelvic organ prolapse surgery [J]. J Clin Nurs，2014，23（17-18）：2637-2648.
[22] Handa VL，Harvey L，Cundiff GW，et al. Sexual function among women with urinary incontinence and pelvic organ prolapse [J]. Am J Obstet Gynecol，2004，191（3）：751-756.
[23] Utomo E，Korfage IJ，Wildhagen MF，et al. Validation of the Urogenital Distress Inventory （UDI-6） and Incontinence Impact Questionnaire （ⅡQ-7） in a Dutch population [J]. Neurourol Urodyn，2015，34（1）：24-31.
[24] Celik DB，Kizilkaya BN,Yalcin O. Sexual function in women after urinary incontinence and/or pelvic organ prolapse surgery [J]. J Clin Nurs，2014，23（17-18）：2637-2648
[25] Barber MD，Walters MD，Bump RC. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders （PFDI-20 and PFIQ-7） [J]. Am J Obstet Gynecol，2005，193（1）：103-113.
[26] Diwadkar GB，Barber MD，Feiner B，et al. Complication and reoperation rates after apical vaginal prolapse surgical repair：a systematic review [J]. Obstet Gynecol，2009， 113（2 Pt 1）：367-373.
[27] Lee U，Raz S. Emerging Concepts for Pelvic Organ Prolapse Surgery：What is Cure? [J]. Curr Urol Rep，2011， 12（1）：62-67.
[28] Roos AM，Thakar R，Sultan AH，et al. Pelvic floor dysfunction：women’s sexual concerns unraveled [J]. J Sex Med，2014，11（3）：743-752.
[29] Braekken IH，Majida M，Ellstrom EM，et al. Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial [J]. J Sex Med，2015，12（2）：470-480.